This study assessed perceptions about teammate and coach approval
of alcohol and other drug use (i.e., injunctive norms) among a sample of
3,155 college student-athletes in their first year of athletic
eligibility. Student-athletes perceived that their teammates were more
approving of alcohol and other drug use as compared to coaches. A
multi-level model analysis indicated that perceived approval from both
teammates and coaches were independently associated with
student-athletes 'alcohol and other drug use behaviors. Future
research should explore whether substance use prevention programs that
target normative beliefs specific to teammates and coaches may reduce
alcohol and other drug use among college student-athletes.

Normative beliefs are one of the strongest predictors of college
student substance use (Buckner, 2013; Neighbors, Lee, Lewis, Fossos,
& Larimer, 2007). According to Social Norms Theory (Berkowitz, 2005;
Perkins, 2002, 2003), individuals often have exaggerated perceptions of
others approval of problem behaviors. These perceptions about
other's approval of problem behaviors (e.g., a perception that
other college students think it is acceptable to use marijuana) are
known as injunctive norms (Borsari & Carey, 2003; Cialdini,
Kallgren, & Reno, 1990; Perkins, 2002; Rinker & Neighbors,
2013). Social Norms Theory suggests that inaccurate injunctive norms may
motivate individuals to increase their own problem behaviors to fit
their view of normal behavior. Research findings among college students
reflect Social Norms Theory, showing that students tend to overestimate
others' acceptability of substance use (Alva, 1998; Baer, 1994;
Barnett, Far, Mauss, & Miller, 1996; Carey, Borsari, Carey, &
Maisto, 2006; Prentice & Miller, 1993; Schroeder & Prentice,
1998) and that those perceptions are related to one's personal use
of substances (Borsari & Carey, 2001, 2003; Larimer, Turner,
Mallett, & Geisner, 2004; Perkins & Wechsler, 1996). Research on
Social Norms Theory also indicates that injunctive norms fluctuate when
considering various groups of others, known as reference groups
(Neighbors, O'Connor, Lewis, Chawla, Lee, & Fossos, 2008;
Patrick, Neighbors, & Lee, 2012). For instance, Neighbors and
colleagues found that college students perceived that their friends had
a lower approval rating of alcohol use as compared to a typical college
student. The authors also found that the perception of friends'
approval of drinking was positively associated with drinking behavior,
while a negative association to drinking was found with the perception
of the typical student's approval of drinking (Neighbors et al.,
2008).

In the literature, a plethora of studies on injunctive norms have
been conducted on the college student population, but only a few studies
on this topic have focused specifically on college student-athletes. One
study found that the injunctive norms held towards a "typical
athlete" reference group were a strong predictor for personal
attitudes towards drinking (Hummer, LaBrie, & Lac, 2009). The other
studies tested several variables' ability to classify
student-athletes as heavy drinkers, with perceptions of their
coaches' attitudes towards alcohol use being one of only a few
variables associated with heavy drinking (Lewis, 2008; Thombs, 2000).
Although these studies were the first to examine injunctive norms held
by student-athletes, they were limited by researching injunctive norms
held towards a single reference group, not allowing researchers to
determine fluctuation between multiple reference groups to identify
which are more strongly related to student-athlete substance use
behaviors.

It may seem irrelevant to study injunctive norms of
student-athletes, since they fall under the "college student"
umbrella; however, the distinction between the two groups is very
important. Compared to non-athletes, student-athletes are at a much
higher risk of using certain substances, particularly alcohol, tobacco,
and marijuana (Doumas, Turrisi, Coll,

This study extends research on injunctive norms held by
student-athletes. Specifically, we compared student-athlete perceptions
of teammates' and coaches' approval of (1) alcohol use and (2)
other drug use (i.e., tobacco and marijuana). We hypothesized that
student-athletes would perceive their teammates to be more approving
than coaches in terms of alcohol and other drug use. We also
hypothesized that student-athlete injunctive norms held towards
teammates would be a stronger predictor of alcohol and other drug use
when compared to student-athlete injunctive norms held towards coaches.
Although no previous studies have compared injunctive norms held towards
teammates and coaches, our hypotheses were drawn from previous studies
that examined college student injunctive norms held towards peers and
parents. These studies suggested that injunctive norms held towards
peers are more strongly linked to drinking than those held towards
parents (Neighbors et al., 2007; Neighbors et ah, 2008; Cail &
LaBrie, 2010). Because coaches often play a mentor or "surrogate
parent" role in the lives of student-athletes (Mastroleo, Marzell,
Turrisi, & Borsari, 2012; Short & Short, 2005), we hypothesized
that injunctive norms held towards coaches would be similar in regard to
norms held about parents.

METHODS

Participants and Procedures

Following IRB approval, college student-athletes were recruited
during the Spring semester of 2012 from 48 NCAA colleges and
universities. Schools were equally divided across level of competitive
play (Divisions I, II, and III) and from each region of the United
States. Each school was invited to participate in the study with an
incentive of receiving a free year's subscription to a web-based
alcohol and other drug prevention program (myPlaybook). Although
participating schools required their freshman and transfer
student-athletes to complete myPlaybook, they did not require the
student-athletes to complete the survey (i.e., there was an option for
them to not consent to the survey and still access the myPlaybook
lessons). Student-athletes who consented to participate in the study
completed the survey immediately prior to participating in the
myPlaybook curriculum. We did not offer student-athletes an incentive to
participate in the study. We excluded student-athletes from the current
analysis if they were younger than 18 or older than 21 years of age or
if they were not in their first year of athletic eligibility.

Measures

Injunctive Norms. Student-athlete injunctive norms held towards
teammates and coaches about drunkenness were each measured with a single
item: "How would the following groups of people (Teammates/Coaches)
feel about you ... Getting drunk frequently?" Student-athletes
rated their perceived approval from 1 = Strongly Disapprove to 5 =
Strongly Approve. Student-athlete injunctive norms held towards
teammates and coaches about other drug use, were each measured as the
average of two items: perceived approval of tobacco use and marijuana
use ([r.sub.teammates] = 0.50; [r.sub.coach] = 0.34).

Substance Use. Drunkenness was measured through the open-ended
survey item, "During the past 30-days, on how many days did you get
drunk?" Other drug use was the average of three items that asked
student-athletes "During the past 30-days, on how many days have
you used the following ... cigarettes, smokeless tobacco (e.g., chewing
tobacco, snuff, dip, or snus), marijuana?" These items were
measured on a 6-point scale (none, once, twice, 3-5 days, 6-9 days, 10
or more days).

Plan of Analysis. We used a paired samples t-test to assess any
difference in student-athlete perceptions of coach and teammate approval
of substance use. To test whether injunctive norms predicted personal
substance use, we used multi-level modeling to control for the nesting
of student-athletes (level 1) in different schools (level 2). We tested
three models: Model 1 only included injunctive norms held towards
teammates, Model 2 only included injunctive norms held towards coaches,
and Model 3 included injunctive norms held towards both teammates and
coaches. The three models were conducted to assess each group's
association to substance use behaviors and determine the unique effect
of each group after controlling for the other group within the same
model. Each model controlled for variables that have been shown to be
associated with student-athlete substance use, including sex (reference
group = female), race/ethnicity (reference group = White), age, seasonal
status (reference group = out-of-season), and level of competitive play
(reference group = Division I) (Cadigan, Littlefield, Martens, &
Sher, 2013; Martens, Dams-O'Connor, & Beck, 2006; National
Collegiate Athletic Association, 2012; Thombs, 2000; Wechsler et al.,
1997; Weaver, Martens, Cadigan, Takamatsu, Treloar, & Pedersen,
2013; Yusko, Buckman, White, & Pandina, 2008).

RESULTS

Demographics

A total of 3,932 student-athletes completed the baseline survey,
which was a return rate of 66.3% of those invited to participate. We
excluded student-athletes who were not between the ages of 18 and 21,
those who were not in their first year of eligibility, and those who had
missing data for any of our measures, yielding a final analytic sample
of 3,155 student-athletes. The demographics of the sample reflect that
of first-year NCAA student-athletes across the country (NCAA 2012). The
majority of student-athletes identified themselves as White (75%) or
Black (11%) and 18 (52%) or 19 (45%) years old. Half of the
student-athletes were male (50%) and just over half (56%) were in-season
when they completed the pre-test survey (Table 1).

Previous research has not compared whether student-athlete
injunctive norms held towards either teammates or coaches had a stronger
association with substance use. To address this gap in the literature,
we compared student-athlete injunctive norms held towards teammates and
coaches using multi-level models that controlled for factors known to
contribute to student-athletes substance use (e.g., sex, race/ethnicity,
seasonal status, division).

The findings from this study supported past research regarding how
perceptions of others' approval of substance use varies across
reference groups (Agostinelli, Grube, & Morgan, 2003; Neighbors et
al., 2008; Patrick et ah, 2012). Our findings indicated that
student-athletes perceived that their teammates were more approving of
drunkenness and other drug use when compared to their coaches. This
greater approval may suggest that student-athletes are more likely to
socialize and use substances with teammates than with their coaches (and
therefore might perceive greater approval from these peers). In
addition, adults are more likely to disapprove of substance use.
However, it is important to note that on average, student-athletes
perceived that both teammates and coaches disapproved of alcohol and
other drug use (i.e., the mean approval for all measures was less than
2, which corresponded to a response of "disapprove").

Consistent with the Social Norms Theory, we found that the
perception of others' approval of substance use is associated with
personal behavior (Berkowitz, 2005). Based on past research comparing
peer and parent norms, we hypothesized that participant perception of
coach approval would be less strongly associated with substance use than
the perception of teammate approval (Cail & LaBrie, 2010; Neighbors
et al., 2007, Neighbors et al., 2008). However, after controlling for
several key factors related to substance use among student-athletes
(sex, race/ethnicity, age, seasonal status, level of competitive play),
injunctive norms held towards teammates and coaches were both
independently associated with self-reported drunkenness and other drug
use. During college, perceived coach approval of substance use may be
more closely linked to substance use than perceived parent approval,
because coaches are generally in a better position than parents to
observe the effects of substance use (e.g., acting sluggish during
practice) and to enforce consequences for this use (e.g., suspended game
play for getting caught using substances). It is also possible that
coaches' behaviors can implicitly discourage or encourage substance
use. For example, by setting formal team policies about substance use
and outlining the consequences for breaking those policies (e.g., not
participating in practice or competition), coaches may convey that
substance use is a serious issue and that this use is a real threat to
interfering with participation in college sports. Conversely, when
coaches do not set up formal policies or somehow convey that they do not
strongly disapprove of substance use, student-athletes may be more
likely to get drunk and use other drugs.

Limitations and Future Directions

The study's findings and limitations suggest several
directions for future research. One notable limitation of the current
study was that we used an observational design. Therefore, even though
injunctive norms were associated with substance use, we cannot conclude
that these norms caused substance use. We attempted to rule out possible
third variable explanations for the association between norms and
substance use by controlling for factors such as the student
athlete's gender, race, age, and whether or not the student was in
season, along with the school's competitive division. Future
studies should also control for other factors, such as substance use
during high school, which has been shown to be a risk factor for
substance use during college (Yu & Shacket, 2001). Our
cross-sectional design also did not allow us to rule out the possibility
of reverse causation. For example, student-athletes who use alcohol or
other drugs may in turn perceive greater approval from their teammates
and coaches, perhaps as a way to justify their own substance use. It is
important to note, however, that results from social norms interventions
have indicated that changing norms can lead to changes in behaviors
(Berkowitz, 2005; Lewis & Neighbors, 2006; Moreira, Smith, &
Foxcroft, 2009; Neighbors, Larimer, & Lewis, 2004). The findings
from these studies, combined with the findings from the current study,
suggest that targeting norms held toward teammates and coaches may be an
effective strategy to reduce substance use among college
student-athletes.

A second limitation is that we only included injunctive norms held
towards teammates/coaches in our models. Although teammates and coaches
are relevant reference groups to student-athletes, there are other
groups whose approval may be important to student-athletes, such as
athletic trainers (Bums, Schiller, Merrick, & Wolf, 2004) and team
captains (Thombs & Hamilton, 2002). Still other reference groups may
be important for college students more generally, such as parents
(Turrisi, Mastroleo, Mallett, Larimer, & Kilmer, 2007), close
friends (Lee, Geisner, Lewis, Neighbors, & Larimer, 2007), and
resident advisers (Thombs & Osborn, 2013). Future studies should
compare these reference groups to determine the relative contribution of
each group to student-athlete substance use. By doing so, researchers
and health professionals can determine which norms to target as part of
their intervention.

A third limitation was that our measures of injunctive norms were
comprised of either a single item (for drunkenness) or two items for
other drug (i.e., tobacco, marijuana) use, so we could not evaluate the
reliability of our measures of injunctive norms. Typically, these items
are combined into a single scale assessing perceived approval for
substance use more generally. Because we were interested in the
independent contributions of injunctive norms toward coaches and
teammates and in the independent effects on drunkenness and other drug
use, we decided to disaggregate the scale and use the items, rather than
the scale, as predictors of substance use. Furthermore, the fact that
these items were significantly associated with substance use and in the
expected direction suggests that they are still appropriate measures of
injunctive norms. However, future studies could add other items to more
completely assess the constructs of injunctive norms towards coaches and
teammates.

A fourth limitation was that we focused exclusively on
student-athletes who were 18-20 years old. It is possible that teammate
and coach approval of substance use may be different among older
student-athletes. For instance, student-athletes may perceive greater
approval of drinking alcohol from teammates and coaches once they turn
21 years old and can consume alcohol legally. We still expect, however,
that this approval would be associated with substance use. By contrast,
we do not expect that approval of other drug use (e.g., marijuana,
tobacco use) would change for older students. Future research should
investigate how perceptions of teammate and coach approval change over
time and whether those perceptions are related to personal substance
use.

Despite these limitations, the findings from this study are
consistent with the possibility that the perception of approval from
one's coach influences substance use behaviors. Future studies
should investigate what aspects of coach behavior affect student-athlete
perceptions of their coaches' approval for substance use. Past
research indicates that a coach's substance use policies may impact
student-athlete perceptions (Williams, 2012); however, other factors may
also affect perceptions about substance use, such as how often coaches
talk about substances or coaches' own use of substances.
Determining which aspects of coach behavior impact perceptions held by
student-athletes would inform interventions that train coaches how to
decrease student-athlete substance use.

Our findings also highlight the importance of expanding studies on
student-athlete injunctive norms beyond alcohol use. Previous studies on
student-athlete injunctive norms have only examined perceptions of
drinking (Hummer et al., 2009; Lewis, 2008; Thombs, 2000), but our work
shows that there is a similar association between injunctive norms and
other drug use. Identifying how student-athletes perceive others'
approval of a wide variety of substances is important for creating
effective, targeted prevention programming towards this population.

CONCLUSION

Despite its methodological limitations, this study contributed to
the literature by comparing the extent to which student-athlete
injunctive norms held towards two reference groups unique to college
student-athletes were associated with their own substance use. Although
student-athletes perceived that their teammates were more approving of
getting drunk and other drug use compared to coaches, both injunctive
norms independently were associated with these behaviors. A possible
explanation of the coach reference group being associated with use may
be a coach's role in forming team dynamics through recruitment,
relationship, and policy formation. These findings have important
implications for future research, such as considering additional
reference groups important to the lives of student-athletes (e.g., team
captains, athletic trainers) that remain unstudied within injunctive
norm research and considering substances other than alcohol for norms
research, as tobacco and marijuana are also substances of concern among
the student-athlete population.

ACKNOWLEDGEMENT

The authors would like to thank the Department of Health and Human
Services for funding this study.

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